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Minna Richards,1 Saija Inkeroinen,1 Jouko Katajisto,2 Sasu Muje,1 Heli Virtanen,1 Helena Leino-Kilpi1,3 1Department of Nursing Science, University of Turku, Turku, Finland; 2Department of Mathematics and Statistics, University of Turku, Turku, Finland; 3Turku University Hospital, Turku, FinlandCorrespondence: Saija Inkeroinen, Department of Nursing Science, University of Turku, Medisiina B, Kiinamyllynkatu 10, Turku, 20520, Finland, Email saanin@utu.fiPurpose: Feedback from service users is a valuable source for improving the quality of care and services, potentially reflecting the successes and failures in providing empowering healthcare. In supporting empowerment, the multidimensionality of knowledge of service users is assumed to be a crucial factor, yet feedback has not been explored from the perspective of empowering knowledge. In this study, the aim was to analyze the knowledge areas expressed in the service users’ feedback from the point of view of empowering knowledge.Patients and Methods: This was a retrospective study utilizing systematically collected service-user feedback from a feedback register of one university hospital district in Finland. Free-form feedback (n = 26,374) along with structured evaluative feedback was given by the patients themselves or their significant others, either by text message or using a feedback form, in 2019. The content of the feedback was analyzed according to the empowering knowledge areas (biophysiological, cognitive, functional, experiential, ethical, social, and financial), quantified, and analyzed statistically in relation to the background characteristics of service users.Results: Service users gave multidimensional free-form feedback about the knowledge and educational practices in care and services. In the free-form feedback, the most common empowering knowledge areas were biophysiological and cognitive ones, whilst experiential, ethical, social, and financial areas were the least common. The highest ratings of structured evaluative feedback were associated with the cognitive and ethical areas.Conclusion: Register-based feedback is systematic data for quality evaluation. In this study, service users seem to actively evaluate the knowledge procession in care and services, and therefore, they can be actors involved in developing the quality of educational practices. It does, however, indicate a need to add multidimensionality and improve the quality of the knowledge, and by that, advance the potential of empowerment among diverse service users.Keywords: empowerment, feedback, health information, hospitals, district, knowledge, patient satisfaction, service users

Saija Inkeroinen,1 Jenni Koskinen,1,2 Mia Karlsson,3 Taina Kilpi,4 Helena Leino-Kilpi,1,5 Pauli Puukka,1 Ros-Marie Taponen,6 Riitta Tuominen,5 Heli Virtanen1 1Department of Nursing Science, University of Turku, Turku, Finland; 2Hematology and Stem Cell Transplantation Unit, Turku University Hospital, Turku, Finland; 3Kidney Center, Department of Medicine, Turku University Hospital, Turku, Finland; 4Turku City Welfare, City of Turku, Turku, Finland; 5Turku University Hospital, Turku, Finland; 6Abdominal Center Dialysis Unit, Hospital District of Helsinki and Uusimaa, Helsinki, FinlandCorrespondence: Saija InkeroinenDepartment of Nursing Science, University of Turku, Turku, 20014, FinlandTel +358400760698Email saanin@utu.fiPurpose: Patient education improves health and treatment adherence of patients with chronic kidney disease. However, evidence about the sufficiency of patients’ knowledge processed in patient education is limited. The purpose of this study was to evaluate subjective and objective sufficiency of knowledge processed in patient education in dialysis care and treatment.Patients and Methods: A cross-sectional study design was used. The sample (n=162) comprised patients in predialysis or home dialysis. All eligible patients during the data collection timeframe (2016– 2017) in two university hospital districts in Finland were invited to participate. Subjective sufficiency was evaluated with a structured questionnaire having 34 items divided into six dimensions of empowering knowledge (bio-physiological, functional, social, experiential, ethical, and financial) on a Likert scale (1=not sufficient at all, 4=very sufficient). Objective sufficiency was evaluated with a structured knowledge test with 10 items (score range 0– 10, correct=1, wrong/no knowledge=0) based on the multidimensional content of patient education emphasizing bio-physiological dimension.Results: In subjective sufficiency of knowledge, the mean was 3.27 (SD 0.54). The bio-physiological dimension of empowering knowledge was the most sufficient (mean 3.52, SD 0.49) and the experiential the least (mean 2.8, SD 0.88). In objective sufficiency, the means ranged 5.15– 5.97 (SD 2.37– 2.68) among patients in different modalities of dialysis care and treatment. The least sufficient objective scores were bio-physiological and functional knowledge. The subjective and objective sufficiency did not correlate with each other.Conclusion: Patients’ knowledge, either subjective or objective, does not seem to be sufficient. Hence, attention should be paid to supporting patients with more personalized knowledge. Furthermore, the relationship between subjective and objective sufficiency needs future consideration, as their non-correspondence was a new discovery.Keywords: chronic kidney disease, hemodialysis, home, patient education as topic, peritoneal dialysis, renal dialysis

Ocean loading models, Baltic Sea loading and atmospheric loading tilt models are compared with the long interferometric water level tilt meter recordings at the Lohja2 geodynamics laboratory in southern Finland. The tilt meter shows a high response to different loading phenomena, and it can be used to study earth dynamics, earth structure modeling, and 2D surface mass loading model validation. Special attention is paid on the Baltic Sea and atmospheric loading tilt oscillations. The four ocean loading models used show deviating values compared to the measured earth tide tilt parameters. The CSR4.0 ocean loading model fits best to analyzed tidal tilt observations at the site. After reductions of earth tides, ocean, the Baltic Sea and atmospheric loading tilt, the largest residual tilt signals are located in frequency bands below 0.5 cycle/day.

Background The digital transformation of healthcare enables new ways of working in cancer care directing attention on the digital skills of healthcare professionals. This systematic review aims to identify existing evidence about digital skills among health care professionals in cancer care to identify the needs for future education and research. Methods Database searches were conducted in PubMed, CINAHL, Web of Science, Scopus, Cochrane and ERIC to identify studies until March 2023. The inclusion criteria were digital skills of health care professionals in cancer care as described by themselves, other health care professionals, patients or significant others. The CASP tool was used for quality assessment of the studies. Data was analysed following inductive content analysis. Results The search produced 4563 records, of which 24 studies were included (12 qualitative, 10 quantitative, 1 mixed methods design and 1 strategy paper). Four main categories were identified describing HCPs’ required skills, existing skills and development areas of digital skills in cancer care: Skills for information technology, Skills for ethical practice, Skills for creating a human-oriented relationship and Skills for digital education and support. In development areas, one more main category, Skills for implementing digital health, was identified. Conclusion The digital skills of health care professionals in cancer care are multifaceted and fundamental for quality cancer care. The skills need to be assessed to provide education based on actual learning needs. The review findings can be used for education and research in this field.

A high-power superluminescent diode emitting over 400 mW in the 1.2 μm range is reported. The active region is based on a single GaInNAs/GaAs quantum well positioned within a low-confinement vertical waveguide and a lateral ridge waveguide geometry, ensuring single transverse mode operation. The peak wall-plug efficiency and the differential efficiency in the linear region were 22.8% and 0.38 W/A, respectively. The full width at half-maximum spectral width for the maximum output power was 22 nm, corresponding to a spectral power density of 19 mW/nm, a threefold increase compared to continuous wave superluminescent diodes based on a quantum dot active region operating in the same wavelength range. Besides exhibiting excellent optical and electrical properties, the GaInNAs active region enhances operation at elevated temperatures. In this respect, an output power of about 210 mW is demonstrated at operation temperatures as high as 60 °C, while 150 mW is still emitted at 70 °C. The unique combination of parameters demonstrated makes these GaInNAs QW-based superluminescent diodes particularly attractive for hybrid integration with silicon photonic circuitry, enabling the demonstration of compact solutions for sensing, optical coherence tomography, and other emerging concepts exploiting photonic integration technology and requiring single transversal mode operation, good efficiency, broadband high spectral power density, and uncooled operation at elevated temperatures. [ABSTRACT FROM AUTHOR]

Background: Finnish men used to have higher semen quality than Danish men. However, recent studies showed that semen quality in Finland has declined, but it has been relatively stable in Denmark. Objective: This study aimed to compare new data on semen quality of the young Finnish men to that of Danish men. Materials and methods: In this cross‐sectional study, 18‐ to 19‐year‐old men residing in Turku, Finland and Copenhagen, Denmark, were invited to participate in 2008–2011. Each man filled in a questionnaire, provided one semen sample and underwent andrological examination. Semen samples were analyzed according to WHO. Multiway ANOVA was used to adjust semen variables for duration of sexual abstinence and age (and time from ejaculation to the start of semen analysis for sperm motility). Results: Altogether 287 Finnish men and 873 Danish men participated in the study. The adjusted median sperm concentrations were 49 and 47 million/mL for Finnish and Danish men, respectively (p = 0.48). The adjusted median total sperm counts were 148 million in Finland and 146 million in Denmark (p = 0.87). The adjusted median percentages of morphologically normal spermatozoa were 6.9% in Finland and 6.5% in Denmark, p = 0.27. Finnish men had higher adjusted median percentages of motile spermatozoa (A+B+C) than Danish men (80% vs. 69%, p < 0.001). The proportion of men who had low semen quality (sperm concentration, percentage of morphologically normal spermatozoa or percentage of progressively motile spermatozoa below WHO reference limits) was lower in Finland (25.4%) than in Denmark (34.6%), p = 0.004. Discussion: Considerable percentage of men in both countries had low semen quality. The deteriorating semen quality in Finland may result in decreasing fecundity, which is a cause of concern. Conclusion: The formerly high semen quality in Finland has converged to the lower Danish levels. Our findings demonstrate the importance of continuing surveillance of semen quality. [ABSTRACT FROM AUTHOR]

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Impaired semen quality and testicular cancer may be linked through a testicular dysgenesis syndrome of foetal origin. The incidence of testis cancer has been shown to increase among Finnish men, whereas there is no recent publication describing temporal trends in semen quality. Therefore, we carried out a prospective semen quality study and a registry study of testis cancer incidence among Finnish men to explore recent trends. A total of 858 men were investigated in the semen quality study during 1998-2006. Median sperm concentrations were 67 (95% CI 57-80) million/mL, 60 (51-71) and 48 (39-60) for birth cohorts 1979-81, 1982-83 and 1987; total sperm counts 227 (189272) million, 202 (170-240) and 165 (132-207); total number of morphologically normal spermatozoa 18 (14-23) million, 15 (12-19) and 11 (8-15). Men aged 10-59 years at the time of diagnosis with testicular cancer during 19542008 were included in the registry study, which confirmed the increasing incidence of testicular cancer in recent cohorts. These simultaneous and rapidly occurring adverse trends suggest that the underlying causes are environmental and, as such, preventable. Our findings necessitate not only further surveillance of male reproductive health but also research to detect and remove the underlying factors. [ABSTRACT FROM AUTHOR]

Aim: To examine the personal expenses for a patient admitted to hospital for a single ambulatory surgical procedure and to determine the factors related to the level of these expenses. Methods: Patients (n = 145) treated in one ambulatory unit during a six-month period during 2004 were included in the study. Results: Patients reported total personal costs from between euro 5 and euro 772. There was a difference between patients' expenses and the type of surgery and the patients' vocational education. Conclusion: Effective interventions that reduce personal expenses are needed to make ambulatory surgery an economic treatment for individual patients. [ABSTRACT FROM AUTHOR]

This empirical study aimed to describe the ambulatory surgical patients' information and control preferences with reference to received knowledge. The results indicate that patients' information preferences and behavioral preferences are not very high, and they seem to receive most knowledge in the biophysiological domain. The most important finding is that patients with higher preferences seem to receive less knowledge than those with lower preferences. The results suggest the need to further study nurses in the ambulatory surgery setting and the extent to which the information expectations of patients are met. Copyright © 2009 by Elsevier Inc. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study to compare orthopaedic ambulatory surgery patients' knowledge expectations before admission and their perceptions of received knowledge 2 weeks after discharge. Background. Advances in technology and population ageing are driving up the number of ambulatory orthopaedic surgical procedures. Shorter hospital stays present a major challenge for patient education. Methods. A descriptive comparative cross-sectional study (pre- and post-test) design was adopted. The data were collected from 120 consecutive patients in 2004, using the Hospital Patient's Knowledge Expectations Scale and Hospital Patient's Received Knowledge Scale. All patients participated in a preoperative education session given by a nurse. Results. Patients expected more knowledge than they actually perceived that they received on all dimensions except the bio-physiological. They perceived that they received least knowledge about experiential, ethical, social and financial dimensions of knowledge. Knowledge expectations correlated with age and professional education. Perceptions of received knowledge correlated with earlier ambulatory surgery, and both expected knowledge and perceptions of received knowledge were related to the level of basic education. Conclusion. Patients' knowledge expectations are greater than the knowledge they perceived that they receive, and they cannot become empowered if they lack important knowledge. Further research is needed to learn about meeting patients' knowledge expectations. [ABSTRACT FROM AUTHOR]

The purpose of this study was to analyze the connections between patient education and health-related quality of life as an outcome variable. Data were collected among surgical hospital patients (n = 237) in Finland. On the basis of the results, there seems to be a positive relationship between received knowledge and health-related quality of life, and as such, the study produced knowledge about one quality indicator in nursing care. More research is needed to explore this connection in greater details. [ABSTRACT FROM AUTHOR]

AIMS: This paper presents a systematic review whose aim was to describe the scope and methods of the current literature on preoperative patient education and to identify the effects of this education. BACKGROUND: Preoperative patient education is a common and important intervention in surgical nursing, yet there is very limited systematic evidence on its precise role. METHODS: The Medline, CINAHL, Eric, Psycinfo and Social Sciences Index databases and the Cochrane Library were searched, covering the period from the beginning of each database to April 2003. Studies were included if they concerned adult orthopaedic patients, preoperative nursing patient education and were based on randomized controlled or clinical trials. Meta-analysis was carried out where appropriate. RESULTS: We identified 11 articles involving 1044 participants. Most studies included one experimental and one control group; only two had more than one experimental and control group. The educational interventions varied widely, but the majority were based on written materials alone, or written materials in combination with other teaching methods. The most common outcome measures related to pain, knowledge, anxiety, exercises and length of stay, and the least common to self-efficacy and empowerment. The methodological quality of the studies varied. Almost all reported one or more statistically significant effects. Based on the findings of the meta-analysis, preoperative education appears to have some impacts on patients' anxiety and knowledge levels. CONCLUSIONS: The review clearly highlights the need for well-designed, methodologically sound research into the outcomes of patient education. It also points to the need to study patient education from the point of view of empowerment. [ABSTRACT FROM AUTHOR]

This study describes Registered Nurses' perceptions of geriatric rehabilitation nursing as well as their experiences of working in the rehabilitation of older patients in Denmark, Finland and Norway. The aim was to gain deeper insights into how Registered Nurses think about geriatric rehabilitation nursing and how their perceptions differ in these countries. The data were collected among 600 Registered Nurses using a structured questionnaire with five background items and 88 geriatric rehabilitation nursing items. The response rate was 65%. Data analysis was with SPSS statistical software. Geriatric rehabilitation nursing was experienced as something that required knowledge and experience, patience and creativity, as well as professional skills. The nurses talked with their patients about their rehabilitation goals, but not all nurses were aware of those goals. Progress in the rehabilitation process was evaluated on a daily basis and results were noted in the patients' records. The nurses motivated patients by giving them positive feedback, by preventing pain, by pausing to share with the patients their joy about progress, and by giving the patients the opportunity to cope with daily activities. The Registered Nurses in Denmark were more team oriented and they set out the goals in the patient's records more often than their colleagues did in Finland and Norway. [ABSTRACT FROM AUTHOR]

There is a common genetic variant of LH due to two amino acid changes in the LHβ subunit, Trp8Arg and Ile15Thr. In order to compare the relative activities of wild type (wt-LH) and variant LHβ (v-LHβ) genes in LH production and secretion, we performed gonadotrophin-releasing hormone (GnRH) stimulation tests for healthy females (n = 7) and males (n = 10) heterozygous for the v-LHβ allele. Blood samples were drawn up to 180 min after injection of GnRH. The serum samples were subjected to two immunofluorometric assays, one detecting wt hormone, the other detecting equally both LH types. The wt/total ratio increased significantly (P ≤ 0.016) after GnRH injection in males. This indicates that the proportion of wt-LH increases in the circulation in men but not in women, and that women consequently secrete relatively more v-LH. An in-vitro bioassay was performed on 0 and 60 min samples, and the bio/immunoreactivity (B/I) ratio decreased in both sexes (P = 0.010–0.012). This supports the previously reported lower B/I ratio of wt than v-LH, since wt-LH is expected to accumulate in circulation because of its longer half-life. In conclusion, these findings demonstrate that wt- and v-LH respond differently to GnRH stimulation in men and women heterozygous for v-LHβ. These results are in agreement with previously documented differences of the two forms in circulation, as well as with different promoter activities of the two LHβ alleles. [ABSTRACT FROM PUBLISHER]